Surgery through a natural orifice poses a number of challenges over laparoscopy or open surgery. Where the surgery is purely endoscopic, i.e., strictly through a natural orifice, the surgeon faces the upfront challenge of gaining adequate access to the desired operative site in the body. For example, many types of surgery require access to the peritoneum. The surgeon may reach the desired location by penetrating the wall of a body lumen, such as a lumen of the gastrointestinal tract. For example, in a transanal procedure the surgeon typically creates a passageway through the wall of the colon to access the peritoneal cavity. Similarly, in a transoral or transgastric procedure the surgeon can create a passageway through the stomach.
Such procedures often involve creating a sterile access point or section of lumen (e.g., an otomy site) at which to penetrate the lumen wall. Because the otomy site and the peritoneal cavity, or other body cavity, can become inflamed and/or infected from microbial or other contamination, sterilization is often of utmost concern. Such concerns are heightened when accessing the peritoneum from the colon. At the same time, the surgeon performing natural orifice surgery faces a significant loss of dexterity and feel, and reduced ability to maneuver surgical tools and devices. Ideally, the access devices and techniques employed by the surgeon can provide a stable and secure transluminal access point through which to operate, and do not unduly hinder the already difficult manipulation of surgical tools and devices into and within the body cavity.
Accordingly, there is a need in the art for novel methods and devices for providing access to a body cavity through the wall of a body lumen. There is also a need for devices and methods that can facilitate the sterilization of a local portion of a body lumen for use as an access point or otomy site for penetration of the wall of the body lumen.